Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Found 1 result for Related Articles by Review for PMID: 39591486
Filters applied. Clear filters
Review

Diagnostic tests and diagnostic thresholds for referral: Adrenal insufficiency: identification and management

No authors listed
London: National Institute for Health and Care Excellence (NICE); 2024 Aug.
NICE Evidence Reviews Collection.
Free Books & Documents
Review

Diagnostic tests and diagnostic thresholds for referral: Adrenal insufficiency: identification and management

No authors listed.
Free Books & Documents

Excerpt

Healthcare providers in a wide range of primary and secondary care settings commonly wonder whether a patient has adrenal insufficiency. The definitive (Short Synacthen) test is complicated and costly to perform, requires specialist interpretation, and is not generally readily available to non-endocrine specialists. In practice, random serum cortisol levels are commonly measured by non-specialists as an adrenal insufficiency screening test, and the patient is referred for further testing if the level is considered abnormal. However, this approach can result in unnecessary referrals. Cortisol secretion is pulsatile and follows a circadian rhythm, and secretion is maximal in the early morning, with levels declining during the evening/night. Cortisol level is also affected by many factors including stress, exogenous steroid, and other medications such as oral oestrogen preparations. Unless these factors are taken into consideration, random cortisol testing is rarely helpful. There are new methods of checking adrenal function -testing salivary cortisol and cortisone.

This review seeks to determine which initial tests should be performed by non-specialists to screen for adrenal insufficiency, and how these tests should be interpreted to determine which patients should be referred for specialist testing and those in whom adrenal insufficiency can be safely excluded.

PubMed Disclaimer

Similar articles

See all similar articles

LinkOut - more resources